赵文霞分期辨治酒精性肝病经验介绍
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R575

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国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教函[2018]134号)。


Experience Introduction of ZHAO Wenxia in Treating Alcoholic Liver Disease by Stages
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    摘要:

    介绍赵文霞教授分期辨治酒精性肝病的临床经验。赵文霞教授认为,酒精性肝病的病机是一个由浅入深,逐渐演变的过程,当分期辨治,首辨疾病阶段,次辨虚实。初期多属实属热,以湿热、痰湿、肝郁多见,方选龙胆泻肝汤、丹栀逍遥散、二陈汤加减等;中期邪气渐盛,正气渐衰,虚实夹杂,以气滞血瘀、痰瘀互结多见,方可选用茵陈蒿汤、膈下逐瘀汤加减;末期正气已衰,正虚邪恋,本虚标实,以肝肾不足、气血水互结多见,当因证而施方药,如脾虚湿盛宜参苓白术散合胃苓汤加减;肝肾不足宜一贯煎联合鳖甲煎丸;脾肾阳虚宜实脾饮合真武汤加减等。

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    Abstract:This paper introduces Prof. Zhao Wenxia's clinical experience in treating alcoholic liver disease by stages. Prof. Zhao believes that the pathogenesis of the disease is a process of gradual evolution from the shallow to the deep, which should be treated by different stages. The first step that we should do is to identify the disease staging,and the second step is to differentiate the deficiency and excess. The disease at early stage mainly belongs to excess and heat, specifically, damp- heat, phlegm- damp and liver depression, and the prescriptions should be modified Longdan Xiegan tang, Danzhi Xiaoyao powder and Er'chen tang. When the disease is at middle stage,with the gradual exuberance of pathogenic qi and the decline of healthy qi as well as the deficiency of healthy qi and the retention of pathogens, the main syndromes are qi stagnation and blood stasis as well as binding of phlegm and stasis, and the prescriptions should be modified Yinchenhao tang and Gexia Zhuyu tang. When the disease is at late stage, healthy qi is deficient and pathogens retain, and with deficiency in origin and excess in superficiality, liver and kidney are insufficient and qi, blood and water are binding, so prescriptions should be determined according to different syndromes, for example, modified Shenlin Baizhu powder combined with Weiling tang if with spleen deficiency and dampness exuberance,Yiguan Jian combined with Biejia decocted pills if with insufficiency of liver and kidney,and modified Shipi yin combined with Zhenwu tang if with spleen-kidney yang deficiency.

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刘江凯,指导:赵文霞.赵文霞分期辨治酒精性肝病经验介绍[J].新中医,2021,53(18):201-204

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  • 在线发布日期: 2021-09-24
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